MIKE KOZMINSKI, M.D. — NPI 1093816316 (Board-Certified Urologist (Urinary Tract, Kidney Stone & Prostate Surgeon) in HART, MI)

CMS-1500 Box 24J / 33a • NPI

1093816316

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

208800000X (CMS 34)

Board-Certified Urologist (Urinary Tract, Kidney Stone & Prostate Surgeon)

Box 32 Service Location & ZIP+4

611 E MAIN ST, HART, MI, 49420-1190

✓ 9-Digit EDI 837 ZIP+4 (49420-1190)

Practice Phone & Referral Fax

(231) 873-6900

Fax: (231) 873-1825

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1093816316 (MIKE KOZMINSKI, M.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1093816316` (NPI-1 Individual Practitioner)
Provider / Legal Name	MIKE KOZMINSKI, M.D.
Plain-English Specialty	Board-Certified Urologist (Urinary Tract, Kidney Stone & Prostate Surgeon) NUCC Code: `208800000X` (Urology)
Certifying / Licensing Body	American Board of Urology (ABU)
Practice Location Address	611 E MAIN ST, HART, MI, 49420-1190
Practice Telephone / Fax	Tel: (231) 873-6900 \| Fax: (231) 873-1825
Administrative Mailing Address	5603 STONEBRIDGE DR SE, GRANDVILLE, MI, 49418
Enumeration & Last Sync	Enumerated: 2006-09-26 \| CMS Record Updated: 2023-03-15

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

611 E MAIN ST, HART, MI, 49420-1190

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Plain-English Taxonomy & CMS Crosswalk (208800000X)

What Does Taxonomy Code 208800000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208800000X translates to:
"Board-Certified Urologist (Urinary Tract, Kidney Stone & Prostate Surgeon)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 34 (Physician/Urology)
Certifying / Accrediting Authority: American Board of Urology (ABU)
Clinical Scope: Kidney stones causing flank pain, blood in urine (hematuria), recurrent urinary tract infections (UTIs), prostate enlargement, or urinary incontinence.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (MIKE KOZMINSKI, M.D.)

Typical CPT / Diagnostic Procedures:

Diagnostic Cystourethroscopy (CPT 52000) & Urodynamic Flow Studies
Ureteroscopy with Holmium Laser Lithotripsy for Kidney Stones (CPT 52356)
Extracorporeal Shock Wave Lithotripsy (ESWL — CPT 50590)
Prostate Specific Antigen (PSA) Screening & Ultrasound-Guided Biopsy

Common Therapeutic Classes:

Alpha-Blockers (Tamsulosin, Alfuzosin) for BPH & Ureteral Stone Passage
5-Alpha Reductase Inhibitors (Finasteride, Dutasteride)
Targeted Urinary Antimicrobials (Nitrofurantoin, Fosfomycin, Ciprofloxacin, Septra)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`174400000X` — Specialist Plain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)	State: MO \| License: `R4J56` \| Primary: Secondary
`208800000X` — Urology Plain English: Board-Certified Urologist (Urinary Tract, Kidney Stone & Prostate Surgeon)	State: MI \| License: `4301049435` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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MIKE KOZMINSKI, M.D. (NPI #1093816316)